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Structural Pain vs. Fibromyalgia Pain

Wed, 22 Feb 2012 06:00:51 +0000

Where is your pain coming from? If you have fibromyalgia, that could be a long answer. One key to understanding the multitude of pain types we have is separating structural pain from purely fibromyalgia-caused pain.

What is Structural Pain?

Structural pain is what most people would think of as "normal" pain: something is wrong with a part of your body - your body's structure - that causes pain. A strained muscle or tendon, an inflamed joint, a broken bone, a malfunctioning organ, etc. can cause structural pain.

Most of us with fibromyalgia have at least one source of structural pain. In fact, many cases are believed to be caused, at least in part, by pre-existing pain. Fibromyalgia takes this pain and makes it worse through a process called pain amplification or hyperalgesia, but fibromyalgia doesn't actually cause this kind of pain.

Fibromyalgia Pain

Fibromyalgia-caused pain, on the other hand, is the stuff that doesn't make sense. It's the sudden stab in the side, even though there's no structural damage there. It's the electrical zap that makes you yell, the odd burning tingle, the all-over ache. It's what makes your feet hurt just because they're cold, and what makes the waistband on your jeans feel like it's it's digging barbs into your skin.

As near as we can tell, these pains are caused by over-sensitized, misfiring nerves. Inadequate blood flow may also play a role, as well as several things going wrong in the brain.

In a nutshell, fibromyalgia pain is the weird stuff, while structural pain is the normal stuff that anyone can get (only it hurts more for us.)

An Important Difference

We need to understand this difference in order to focus treatment on the right type of pain. While we don't fully understand fibromyalgia pain, we do know that lowering pain levels can help quiet down other symptoms. As you probably know, that's easier said than done.

However, if you have a cause of chronic structural pain, you may get your best results from making that the focus of your treatment. A lot of people do otherwise - for example, when someone with osteoarthritis develops fibromyalgia, they may spend a lot more time, money and energy trying to treat the fibromyalgia instead of being more aggressive with the arthritis. I know that happened to me early on. I basically stopped treating my long-time chronic neck and back pain because they didn't hurt as much as the fibromyalgia. That wasn't a good thing to do.

When we do that, we allow pain signals to bombard our brains, and some studies show that continual bombardment can actually alter the physical structure of our brains and cause pain to be processed in an abnormal way. That may even be one of the contributing factors to many cases of fibromyalgia.

The good news is that structural pain is often easier to treat than fibromyalgia pain. When I finally started focusing on my structural pain again, my fibromyalgia pain (and other symptoms) eased up. When my structural pain gets out of control, the other symptoms start to sneak back in.

That's not to say we should stop treating fibromyalgia. Just don't let it distract you from treating the very thing that could be keeping your system all stirred up.

Of course, with fibromyalgia there are no hard and fast rules. Some causes of structural pain, such as that from a progressive illness, are much harder to stay on top of. Sadly, as the disease progresses and the pain increases, your fibromyalgia will likely become worse. If that's the case for you, it might be better to combat the fibromyalgia more directly.

What kinds of structural pain do you have? Have you quieted your fibromyalgia symptoms by treating structural pain? What worked for you? Have you neglected treatment of structural pain due to fibromyalgia? Leave your comments below!

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Working Memory Problems in Fibromyalgia & Chronic Fatigue Syndrome

Mon, 20 Feb 2012 06:00:32 +0000

Do you walk into a room only to forget why you're there? Do you forget what's on your grocery list as soon as you look away from it, or have trouble following step-by-step instructions?

Those are all symptoms of a working memory impairment, which is a common part of the cognitive dysfunction (brain fog or fibro fog) caused by fibromyalgia and chronic fatigue syndrome.

Working memory impairment can disrupt daily life, cause problems on the job, and be incredibly frustrating. For me, it was a chief reason I had to leave my old job. It's also This is generally the symptom that makes us wonder if we're heading toward some kind of dementia. (Which, fortunately, we're not!)

Learn more:

Do you have working memory problems? What has this symptom done to your life? Leave your comments below!

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Photo © Tom Fullum/Getty Images

Men With Fibromyalgia: Special Problems & Symptoms

Sat, 18 Feb 2012 06:00:57 +0000

Fibromyalgia may prefer women, but it doesn't stick exclusively to them - it hits men, too.

Doctors may not even consider fibromyalgia in a male patient, and some doctors speculate that only 10% of diagnoses are men because men are less likely to complain about pain.

Because men are the minority in this case, we know less about how fibromyalgia effects them. However, we do know that it's not quite the same as it is in women. Find out what information we have about the difference:

Fibromyalgia in Men

To the men among us - how do you think this illness is different for you, in terms of both symptoms and social aspects? Was it hard for you to be diagnosed? Have you faced extra scorn for having a "women's illness?" Leave your comments below!

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Poll: Hair Problems With Fibromyalgia

Fri, 17 Feb 2012 06:00:30 +0000

Every time I write about fibromyalgia hair problems here, it gets a huge response. A lot of people don't even realize their hair issues could stem from their illness.

I thought it was time to take a poll and see which problems are most common in us. Some of the poll items have to do with the health of the hair, while others are about styling and taking care of it.

I've heard it said that the hair can tell you a lot about a person's health, and at least in my case, that's been accurate. My stylist can tell when I'm going through a rough time because of the hair loss, or when I've recently had a rough time because of all the new hairs coming in. My friends know I'm not doing well when they consistently see me in a hat. (I do love the hair-styling avoidance my hats allow!)

What hair problems do you have? Take the poll, then have a look at these hair-related conversations:

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Bowel Parasite May Lead to Chronic Fatigue Syndrome

Wed, 15 Feb 2012 06:00:40 +0000

Research Brief

A new study out of Norway suggests that the bowel parasite Giardia lamblia lead to an increased rate of chronic fatigue syndrome (ME/CFS).

Researchers focused on a population that was hard hit by a waterborne outbreak of Giardia enteritis, which included 1,262 people. They first identified a group of 96 people with long-lasting post-infectious fatigue, then evaluated this group for ME/CFS.

Of those 96 people, 58 (60%) were diagnosed with ME/CFS. That's about 4.5% of the people affected by the outbreak.

The study was conducted just over 2.5 years after the outbreak. Over that time, 57% those who's developed ME/CFS said their illness had gradually worsened, 28% said it had stayed constant, and 16% said they'd seen improvement.

Researchers noted a distinctive pattern of impairment that included poorer physical function, more fatigue and low energy, and lower rates of social functioning.

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Photo © Tom Le Goff/Getty Images

Group Behind Retracted XMRV Paper Holds On to Grant Money

Mon, 13 Feb 2012 19:37:23 +0000

NEWSBRIEF: The Whittemore Peterson Institute (WPI) in Reno, NV, has managed to keep a 5-year, $1.5-million U.S. government grant in spite of firing the principal researcher named on the grant.

WPI fired Judy Mikovits in late 2011 after the institute's high-profile paper linked XMRV to chronic fatigue syndrome was retracted by the journal Science. WPI has said the firing was not related to the retraction.

According to ScienceInsider, Representatives of the National Institute of Allergy and Infectious Diseases, which is a division of NIH, visited WPI and determined that Vincent Lombardi had the expertise to replace Mikovitz as the principal investigator. Lombardi was the co-author of the XMRV study.

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Hair Problems in Fibromyalgia

Thu, 09 Feb 2012 06:00:32 +0000

Fibromyalgia affects everything, from your hair to your toenails. And if you're thinking, "Hey, I wonder if my hair problems are related to fibromyalgia," there's a good chance they are.

The biggie is that we're prone to hair loss - which, fortunately, is temporary. For most of us, the hair falls out more when we're going through flares or periods of high stress. It does grow back, which is good, but often leaves us with wispy baby hairs that make it look messy when we pull it back. You might also lose enough that it's noticeably thinner.

But I started thinking about other types of hair problems when I came across this recent comment from a reader:

"I keep my long hair braided or in a soft bun, because my hair moving around causes pain. Can't pull it in a pony tail, for the same reason." -Robbie

I'm sure this issue isn't hers alone. I know fibromyalgia has been a big influence on my hairstyle at times.

The picture of me on this page (which is badly in need of updating) shows what I call my "too sick to do my hair" hairstyle. As my functionality improved, I changed it to something that takes a little work, but not much. And still, I have a wide selection of hats for days when I'm just not up to styling it. I have a huge problem in the summer, because my forehead sweats excessively when I'm warm (another fibromyalgia symptom) and undoes my do in a hurry.

I've read dozens of comments from people who say they can't hold their arms up long enough to style their hair, which is a common complaint in chronic fatigue syndrome, as well.

Barrettes, head bands, clips, etc. often just look too painful to even consider putting on my head. And then there's the styling products - a horror for anyone with fragrance or chemical sensitivities!

It may seem like a hairstyle is inconsequential when you've got a few dozen symptoms to contend with, and really, it's way down on the list of my concerns. However, not being able to style your hair like you want can have a big impact on your self-esteem. It can also be a reminder of all that you've lost to illness.

What has fibromyalgia meant for your hair style? Has pain, energy or hair loss been the bigger factor? What emotional impact has it had on you? Leave your comments below!

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Pain & Cognitive Function in Fibromyalgia

Wed, 08 Feb 2012 06:00:18 +0000

You're going to like this.

A few days ago, a German researcher told the 6th World Congress of the World Institute of Pain that, according to his latest study, the cognitive dysfunction (fibro fog) of fibromyalgia is primarily related to one single factor.

That factor is not depression. It is not anxiety. It is not even unrefreshing sleep.

That factor is: Pain.

And get this - his research team hypothesized that the fibromyalgia participants who were on opiates (narcotics) would demonstrate more cognitive impairment than those who weren't. It's only logical, right?

Apparently not. The fibromites on opiates actually had better cognitive function. Why? Because they had less pain.

That's pretty darned significant to me! When you take a drug that makes most people all kinds of loopy and causes obvious impairment, then scientifically demonstrate that our pain is actually harder for the brain to deal with, it says volumes.

And it's not that depression, anxiety and sleep disorders don't cause cognitive problems. It's well established that they do. But this researcher, Stefan Duschek, PhD, says that in us, pain is the only thing that determines how significant fibro fog is. I really like this guy.

I hope the doctors who want to chalk up fibro fog (and other symptoms) to "just depression" will take note of what Duschek is saying: lower our pain, increase our cognitive function.

As to why our particular form of pain is so hard on the brain, Duschek told Medscape Medical News:

"Pain is an attention-demanding condition; one may suppose that *central nociceptive activity detracts from cognition by requiring enhanced neural processing resources."

It's like the brain is a computer and our unique pain is a program that takes an overwhelming amount of processing power, so everything else slows down and things start to glitch.

This is a massive affirmation of what fibromites have known for decades and what far too many doctors have continued to deny. To borrow a phrase, it's the pain, stupid.

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7 Types of Fibromyalgia Pain
Understanding Fibro Fog
*Definitions: Central Sensitization & Nociceptors
Treating Fibromyalgia

Smoking, Oxidative Stress, Fibromyalgia & Chronic Fatigue Syndrome

Tue, 07 Feb 2012 02:03:56 +0000

We all know smoking is bad for us. But did you know smoking may exacerbate symptoms of fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS)?

We have a handful of recent studies showing smoking makes FMS symptoms more severe:

One from the Mayo Clinic showed higher pain intensity, fewer good days, and more missed work;
A Turkish study linked cigarettes to more severe FMS symptoms as well as more anxiety and depression;
And Korean researchers found more tender points and depression.

An older Scandinavian study showed significantly more pain and numbness, more severe symptoms overall, and more functional problems in smokers with FMS. (However, this study did not show a difference in tender-point count.)

In ME/CFS, the effect of smoking hasn't been scientifically measured. In both conditions, though, the role of oxidative stress is getting more and more of researchers' attention and evidence is mounting that it plays a key role, and possibly a causative one. (For a look at the latest research and what oxidative stress is, see: Oxidative Stress in Chronic Fatigue Syndrome.)

In a nutshell, oxidative stress is caused by an excess of free radicals, which damage your health. Smoking is known to introduce a huge amount of free radicals to your system (as is second-hand smoke.) It also depletes antioxidants, which neutralize free radicals. That means cigarette smoke puts you at high risk for oxidative stress. If oxidative stress is a partial cause of FMS and ME/CFS, it's not a stretch to say that smoking could be a major contributor to the development and severity of them.

So the bottom line is that you have more reason to stop smoking - or avoid second-hand smoke - than you thought. Does that make it any easier to quit? Hopefully it'll up your motivation, but even then, it's still an incredibly difficult thing to break that addiction. Here are resources that can help, from About.com's Smoking Cessation Guide Terry Martin:

For information on fighting oxidative stress, see: Antioxidants for Fibromyalgia & Chronic Fatigue Syndrome.

Do you smoke? Have you quit smoking? What impact did it have on your symptoms? How did you do it? Leave your comments below!

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Antioxidants for Fibromyalgia & Chronic Fatigue Syndrome

Fri, 03 Feb 2012 06:00:06 +0000

One theory of fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) is that oxidative stress plays a key role and possibly a causative one as well. Evidence in support of this theory is growing - I recently reported on the latest study of oxidative stress in ME/CFS. (You can read that, along with an explanation of what oxidative stress is and how antioxidants help, here: Oxidative Stress in ME/CFS.)

You've probably heard a lot of hype about antioxidants and how they're essential for staving off myriad diseases. While some of the information in the popular media is over blown, there is solid evidence behind the benefits of antioxidants at countering oxidative stress, which can trigger illness - possibly including heart disease and cancer.

So how do you get more antioxidants? Food and supplements are the main ways.

Antioxidant-Rich Foods

According to a USDA study, several of the best common-place antioxidant-rich foods are beans and berries. My About.com colleague Cathy Wong, Guide to Alternative Medicine, has a list of the USDA's 20 top foods: Best Food Sources of Antioxidants.

Several of the foods profiled in my Food of the Week series contain antioxidants, including:

A lot of products in the grocery store are labeled as containing antioxidants, but the best sources are generally the natural ones - which are often less expensive and better for you over all.

Antioxidant Supplements

You have a lot of choices when it comes to antioxidant supplements, including:

CoQ10
Rhodiola Rosea
Theanine
Vitamin C
Vitamin E
Beta Carotene
Selenium

Along with increasing antioxidant intake, you can combat oxidative stress by avoiding things that cause free radicals in your body. For more, see: Smoking, Oxidative Stress, FMS & ME/CFS.

Have your symptoms improved due to antioxidants? Which kind(s) did you use? What was the effect? Leave your comments below!

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